# MONTICELLO MEDICAL CLINIC, PLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MONTICELLO MEDICAL CLINIC PLC
- **Other names:** MMC-Star City Satellite Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1982193975
- **Legal business name:** MONTICELLO MEDICAL CLINIC PLC
- **Authorized official:** SYLVIA SIMON M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (870) 367-6867

## Contact information

- **Practice address:** 1306 N. LINCOLN AVENUE, STAR CITY, AR 71667
- **Practice address phone:** (870) 628-1388
- **Practice address fax:** (870) 628-1347
- **Mailing address:** 906 ROBERTS DR, MONTICELLO, AR 71655-5724
- **Mailing address phone:** (870) 367-6867
- **Mailing address fax:** (870) 367-1461

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MC-1891 | AR | Yes |

## Other

- **Enumeration date:** 05/04/2018
- **Last updated:** 05/04/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 139812002 | — | AR |